Q&A With James Ballinghoff, DNP, MBA, RN, NEA-BC

In December, he took on an additional role, as University of Pennsylvania Health System Chief Nurse Executive. He works closely with the School of Nursing, maintaining the strong partnership between Penn Medicine and the school, where he serves as Assistant Dean for Clinical Practice. Ballinghoff’s nursing career started in critical care, and in 2015, he was one of the leaders in moving level one trauma care from the Hospital of the University of Pennsylvania to Presbyterian. Dr. Ballinghoff was the first graduate of Penn Nursing’s Post-Master’s DNP program.

What was your first nursing job?

I worked in critical care as a nursing assistant at Cooper University Hospital while I was going through nursing school. I was just so impressed with the nurses, and a lot of them took me under their wing. I was fortunate to be able to start my career in critical care.

What drew you to critical care? 

I was always drawn to the technology and the critical thinking piece of it. It’s fast- paced, and I’m a fast-paced type of guy.

What ways does nurse leadership impress you in Presbyterian ICUs?

I see examples of critical care nurses providing amazing care just about every day on every shift. It could be a nurse picking up on subtle changes in hemodynamics and intervening and potentially saving a life. We have extracorporeal membrane oxygenation, ECMO, basically bypass, so that the heart and lungs can rest. It’s a lot of machinery and technology. The patients literally have tubes coming out that are in their heart, in their lungs, oxygenating their blood. And the nurses developed a program to get the patients up and moving, which strengthens their bodies and decreases length of stay at the hospital. We’ve had otherwise healthy pregnant women whose bodies fail on them. It could be COVID or an immune response. They’re near death—and we bring them back, and deliver their babies. Then there are kids with multiple gunshots who have basically lost all of their blood. Through critical care interventions and the care that they receive here, they end up walking out or at least getting to rehab. It’s amazing.

What feedback do you get from patients?

It can be very, very difficult for families. For the most part, people are very grateful. But families can also be mistrusting. They Google “car crash” and see you should have this or that, and we’re doing something a little bit different. Maybe the scenario’s different, there could be underlying diseases.

So communication with families is important in ICUs?

When I was at the bedside, I would always go into the patient room and introduce myself and say, “This is what’s going to happen for the next 12 hours while I’m here. These are the goals. You’re going to hear alarms and dings and sounds from the machinery—and it may look like nobody is responding. But if there is an emergency, there will be five to 10 people in this room within seconds, I assure you.”